We have noticed that our almost three year old daughter, who has had diabetes for two years, does not have tears when she cries or has very few when she experiences much pain after falling.She has been like this since birth but has never complained about her eyes. I consulted an eye specialist who examined and told us that her eyes are normal, and she does not have any problem. Is it normal not to have tears while crying? Could this condition be related to her diabetes?

Answer:

Even though your story does not too have enough data for us to make a proper diagnosis, it might be suggestive of Sicca Syndrome which is sometimes associated with type 1 diabetes, and the eye specialist who saw her should have suspected it. Therefore, another eye consultation is mandatory to rule out or to confirm the diagnosis and to address your questions in a proper way.

Additional comments from Dr. Charles Garcia:

I might suggest you consult an ophthalmologist that specializes in the cornea and or a pediatric ophthalmologist. If you are near a medical school you may consult with the eye department there.
There is a rare condition of children born with absent or hypoplastic lacrimal glands known as alacrima. There is an association with the
Riley-Day syndrome.

The tears from emotion (reflex tears) are produced by the lacrimal gland and the tears that bath the eye under non-emotional conditions (basal tears) are produced by the lacrimal gland and accesory lacrimal glands. The fact that emotional tears are not produced may only slightly put the eye at risk for dry eye complications if the alternate tear source is still intact. And the eye can be tested for dry eye complications by a simple topical dye test.

You may want to pursue this issue untill you get a satisfactory answer.

Last Updated: Tuesday April 06, 2010 15:09:46
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